World Health Organization : Year 2002 ; Communicable Diseases and Emerging Infectious Diseases ; Tuberculosis, No. 2002.296: Strategic Framework to Decrease the Burden of TB/HIV

By World Health Organization

Book Id: WPLBN0000147262
Format Type: PDF eBook:
File Size: 0.3 MB
Reproduction Date: 2005

Title:	World Health Organization : Year 2002 ; Communicable Diseases and Emerging Infectious Diseases ; Tuberculosis, No. 2002.296: Strategic Framework to Decrease the Burden of TB/HIV
Author:	World Health Organization
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Health Organization, B. W. (n.d.). World Health Organization : Year 2002 ; Communicable Diseases and Emerging Infectious Diseases ; Tuberculosis, No. 2002.296. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
1 Executive summary The unprecedented scale of the epidemic of HIV-related tuberculosis demands effective and urgent action. The strategic goal is to reduce tuberculosis transmission, morbidity and mortality (while minimising the risk of anti-tuberculosis drug resistance), as part of overall efforts to reduce HIVrelated morbidity and mortality in high HIV prevalence populations. This evidencebased paper concentrates specifically on tuberculosis control in high HIV prevalence populations, while addressing those aspects of the HIV epidemic relevant to tuberculosis. It is complementary to the Global Health Sector Strategy against HIV/AIDS under development by WHO. It sets out a new WHO/UNAIDS strategic framework to decrease the burden of the intersecting epidemics of tuberculosis and HIV (TB/HIV). Instead of the previous “dual strategy for a dual epidemic”, the new framework represents a strengthened unified health sector strategy to control HIVrelated tuberculosis as an integral part of the strategy for HIV/AIDS.

Table of Contents
Contents List of abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 1. Executive summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 2. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 3. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 3.1 Global HIV epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 3.2 The burden of HIV-related disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 3.3 How HIV fuels the tuberculosis epidemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 3.4 Global TB/HIV epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 3.5 Tuberculosis in the course of HIV infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 3.6 The clinical picture of HIV-related tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 4. The international response to TB/HIV: an evolving approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 5. Interventions to control tuberculosis in high HIV prevalence populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 5.1 Tuberculosis case-finding and treatment to ensure cure . . . . . . . . . . . . . . . . . .17 5.2 Additional measures beyond tuberculosis case-finding and treatment . . . .19 5.2.1 Interventions directly against tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 5.2.1.1 Preventive tuberculosis treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 5.2.1.2 BCG immunisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 5.2.2 Interventions against HIV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 5.2.2.1 Interventions to decrease HIV transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 5.2.2.2 Antiretroviral therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 5.2.2.3 Interventions against other HIV-related diseases to decrease morbidity and mortality in HIV-infected tuberculosis patients . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 6. A coherent health service response to TB/HIV . . . . . . . . . . . . .25 6.1 Rational criteria in determining priority interventions . . . . . . . . . . . . . . . . . . . . . .25 6.1.1 Poverty alleviation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 6.1.2 Market failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 6.1.3 Cost of interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 6.1.4 Cost-effectiveness of interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 6.2 A framework for HIV/AIDS care which incorporates interventions to address tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 6.2.1 Home and community care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 6.2.2 Primary care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 6.2.3 Secondary care . . . . . . . . .